Individual
MICHAEL EVAN SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
551 S HOVER ST, LONGMONT, CO 80501-7920
(720) 864-4394
Mailing address
400 CHEYENNE DR, LAFAYETTE, CO 80026-9229
(720) 280-2701
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17383
CO
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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